FORM 1023-EZ for BLIND WITH VISION

Field Data
EIN 81-4810643
Case Number EO-2017128-000246
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLIND WITH VISION
Organization’s Mailing Address 5699 N CENTERPARK WAY
City GLENDALE
State WI
ZIP 53217-1749
Accounting period End 12
Primary contact name JEFFREY BRYANT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEFFREY BRYANT
PRESIDENT
5699 N CENTERPARK WAY
GLENDALE WI 53217-1749

Officer/Director/Trustee Two

RONALD HUNT
VICE PRESIDENT
5699 N CENTERPARK WAY
GLENDALE WI 53217-1749

Officer/Director/Trustee Three

BEV JOHNSON
CORPORATE SECRETARY
5699 N CENTERPARK WAY
GLENDALE WI 53217-1749

Officer/Director/Trustee Four

ROBERT VILLA
TREASURER
5699 N CENTERPARK WAY
GLENDALE WI 53217-1749

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/4/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P86 - Blind/Visually Impaired Centers, Services
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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